Prosthesis liner

ABSTRACT

A prosthesis liner provided for fitting over a stump of a limb. The prosthesis liner includes a main body having an inner face directed towards the skin of the stump, and an outer face directed away from the stump. The prosthesis liner also includes a proximal access opening and a side wall, which extends from the access opening as far as a closed distal end portion of the liner. At least one sealing lip is arranged on the outer face of the main body and protrudes radially outwards from the main body.

TECHNICAL FIELD

The present disclosure relates to a prosthesis liner, which is providedfor fitting over a stump of a limb. The prosthetic liner includes a mainbody, which has an inner face directed towards the skin of the stump andan outer face directed away from the stump, a proximal access opening,and a side wall, which extends from the access opening to a closeddistal end portion.

BACKGROUND

Prostheses are intended to replace missing body parts or limbs and maybe fastened in different ways to a patient. One possibility forfastening a prosthesis, in particular a prosthesis of an upper or lowerextremity, to a patient is to provide the prosthesis with a socket,which is secured to a stump of the limb. This so-called sockettechnology is widely used. Direct bearing of a prosthesis socket on thestump may be problematic, since the prosthesis socket, which generallyis designed with a closed cross section and made of a dimensionallystable material, may lead to pressure points or chafing. In addition,the prosthesis socket does not typically account for volume compensationof the stump of the limb, or only provides limited volume compensation.

In order to uniformly distribute the pressing forces that occur duringthe use of the prosthesis socket and to provide cushioning, and to makeavailable a protective layer for the skin of the stump, prosthesisliners have been developed which are made of an elastic material and aresleeve-shaped with a closed distal end piece. The prosthesis liner isrolled down upon itself for fitting, the stump is inserted with thestump end into a distal end piece of the liner, and the prosthesis lineris then rolled up over the stump.

Alternatively, the prosthesis liner is inverted, such that the actualinner face is located on the outside prior to fitting. The prosthesisliner is thus turned inside out. The stump end is placed onto the closedtip of the inverted prosthesis liner, and the prosthesis liner is fittedby being pulled over the stump. The prosthesis liner thus extends over aportion of the stump along the skin surface and serves as anintermediate piece between the stump and the prosthesis socket.Mechanical locking features (e.g., pin locks) may be provided at thedistal end area of the prosthesis liner. The mechanical locking feature(e.g., a pin) is inserted into a receiving facility in the prosthesissocket and is locked there with form-fit engagement.

Suction socket technology is an alternative or a supplement to form-fitlocking. Suction socket technology includes a closed cavity providedbetween the outer face of the prosthesis liner and the inner face of aprosthesis socket. This cavity is provided with an reduced pressure. Thereduced pressure in relation to the environment may be generated via anelectrical or mechanical pump. Alternatively, the air from the closedcavity is forced out through a non-return valve via a pump movementduring walking or by actuation with the prosthesis. In order to removethe prosthesis, the valve is opened, ambient air flows into the closedcavity, and the prosthesis socket may be removed.

The inner face of the prosthesis liner may be designed to provideadherence or may be provided with an adhesive coating, for example, viaa silicone layer, which adheres relatively well to the skin surface of astump. The cavity may be formed in part by turning an upper end of theprosthesis liner back over the upper end of a prosthesis socket.

SUMMARY

One object of the present disclosure is to provide a prosthesis linerwhich provides improved safety against slipping and gives enhancedwearing comfort as compared to other types of liners. Advantageousembodiments and developments of the present disclosure are disclosedwith reference to the description and figures.

The prosthesis liner according to the present disclosure, which is sizedfor fitting over a stump of a limb, includes a main body having an innerface directed towards the skin of the stump and an outer face directedaway from the stump, a proximal access opening, and a side wall, whichextends from the access opening to a closed distal end portion. At leastone sealing lip is arranged on the outer face of the main body andprotrudes radially outwards from the main body. The at least oneradially outwardly protruding sealing lip may provide improved sealingand thus a controlled cavity between the outer face of the prosthesisliner and the inner face of the prosthesis socket. In the state when theliner is not inserted into the prosthesis socket, the sealing lipprotrudes radially outwards from the main body, such that the outer faceof the sealing lip has an increased external diameter as compared tothat of the main body. An increased external diameter provides improvedbearing on the prosthesis socket, such that the cavity between theprosthesis liner and the prosthesis socket is safely formed. By virtueof this cavity safely sealed off by the sealing lip, it is possible togenerate a stable reduced pressure or a vacuum inside the cavity, suchthat during a movement of the prosthesis the prosthesis socket is heldmore securely on the prosthesis liner.

In a development of the present disclosure, provision is made that thesealing lip has a portion inclined or angled in the direction of theaccess opening, such that the sealing lip has a diameter increasing inthe distal-proximal direction. The portion of the sealing lip inclinedin the direction of the access opening provides the option of moreeasily inserting the stump into the prosthesis socket and generating aspontaneously increasing sealing effect in the event of a possiblepulling-off movement.

The sealing lip is pressed against the inner face of the prosthesissocket as soon as a reduced pressure has formed in the cavity betweenthe outer face of the prosthesis liner and the inner face of theprosthesis socket in the area distally with respect to the sealing lip,which results in a spontaneously increasing sealing effect. The greaterthe reduced pressure, the higher the contact pressure applied to theproximal side of the sealing lip.

The side wall of the main body has a closed cross section, preferablydistally with respect to the sealing lip, in order to ensure thatsealing takes place distally with respect to the sealing lip. The closedcross section includes a continuous, unbroken structure around aperiphery or circumference of the main body. The cross section of theside wall may be closed along the entire length of the prosthesis liner,thereby ensuring that the prosthesis liner bears circumferentially onthe stump or the limb along its entire length.

In one embodiment of the present disclosure, the inclined or angledportion of the sealing lip is straight or curved. A curved sealing lipcross section may provide an increased bearing area on the inner face ofthe prosthesis socket if the curvature is formed in the direction of themain body. The curvature may be formed away from the main body or in thedirection of the main body. In the case of a curvature away from themain body, the bearing pressure of the sealing lip becomes greater as anreduced pressure in the closed cavity or interspace between the outerface of the prosthesis liner and the inner face of the prosthesis socketincreases. In the case of an oppositely directed curvature, removal ofthe stump is made easier and, if appropriate, an increased sealingsurface is made available.

The inclined or angled portion of the sealing lip may be adjoined by aproximal portion oriented in the direction of the main body, such thatthere is a roof-like cross section or a bulged cross section in thestate when the prosthesis liner is not fitted onto the stump. Theproximal portion oriented in the direction of the main body may providestiffening or stabilizing of the sealing lip. In addition, a bearingedge or sealing edge may be generated that bears on the inner face ofthe prosthesis socket when the prosthesis liner is inserted into theprosthesis socket in a way that provides improved stability.

The proximal portion may extend as far as the outer face of the mainbody, such that the proximal portion of the sealing lip at leastpartially lies on the main body or bears on the main body. The proximalportion may lie with its free end on the outer face of the main body,such that a volume is enclosed between the main body and the sealinglip. The bearing of the proximal end of the sealing lip on the outerface of the main body may increase the stability and strengthen theresistance to deformation of the sealing lip during insertion, such thatan increased pressure of the sealing lip against the inner face of theprosthesis socket is made available after insertion.

The sealing lip may be cast onto the main body. For this purpose, it isadvantageous if the sealing lip is made of a material that is identicalto that of the main body. In addition, it is possible that the materialof the sealing lip is not identical to the material of the main body butis made from a similar type of material, for example a silicone or acrosslinked polymer, wherein the material of the sealing lip may beproduced from a silicone or polymer which, for example, is harder thanthe material of the main body. For casting the sealing lip onto the mainbody, it is essential that the material of the main body and thematerial of the sealing lip crosslink with each other, in which case itis safe for the material of the main body to be already partiallycross-linked during the casting of the sealing lip. The main body mayalso be cast onto the sealing lip. Casting the sealing lip onto the mainbody or casting the main body onto the sealing lip results in apermanent connection therebetween, and the main body and sealing lip maybe considered an integral, single-piece structure after the casting.

In addition to the embodiment of the sealing lip made from the samematerial as the material of the main body, it is also possible that thesealing lip is made from a material different than that of the mainbody. Casting is then likewise possible when both materials crosslinkwith each other regardless of the materials used for the main body andsealing lip. The casting takes place in a separate production stepwhich, for example in the casting of a sealing lip, takes place afterthe formation of the main body, at least with partial crosslinking.

In an embodiment of the sealing lip made from the same material as themain body, the sealing lip may be adhesively bonded or welded to themain body. In addition to securing the sealing lip on the outer face ofthe main body by adhesive bonding or welding, both when the sealing lipis made from the same material as the main body and when made from adifferent material than the main body, the inclined or angled portion ofthe sealing lip may be partially embedded in the main body, such asbeing cast into the main body. In this embodiment, the sealing lip isproduced separately and kept in the mould for the prosthesis liner. Thematerial of the main body is then added and guided partially around theinclined portion of the main body to embed the sealing lip in the mainbody. The part of the inclined portion of the sealing lip embedded inthe main body may have holes or apertures through which the material ofthe main body may pass, such that a form-fit connection may take placein addition to a possible crosslinking with the material of the sealinglip.

The sealing lip may extend completely circumferentially around the mainbody in order to ensure complete sealing of the cavity that is formedwith the prosthesis socket distally with respect to the sealing lip. Thesealing lip may form a sealing edge which lies in a plane perpendicularto the longitudinal extent of the prosthesis liner. It may also bepossible to allow the sealing edge or the radially outer area of thesealing lip to extend in a plane that is oriented at an inclination tothe longitudinal extent of the prosthesis liner.

In addition to an integral configuration of the sealing lip togetherwith the main body, it is possible that the sealing lip is designed as aseparate component and is secured on, cast into or cast onto the mainbody.

The sealing lip may be arranged proximally with respect to the distalend area of the prosthesis liner, in particular proximally with respectto the first distal third of the main body, such that at least one thirdof the length of the prosthesis liner is used to form a cavity with theprosthesis socket. In one embodiment, the sealing lip may be arranged orsecured on the main body at the middle of the main body, e.g., half wayalong the length of the prosthesis liner, or else proximally thereto, inorder to provide an increased holding force via the reduced pressureprovided by a larger cavity.

In another embodiment, the outer face of the prosthesis liner is free oftextile, e.g., is made from the base material of the main body. As analternative to making the outer face of the prosthesis liner from thesame material as the main body, the outer face may be provided with afriction-reducing or friction-minimizing coating, via which a change ofthe chemical or physical properties of the outer face may be achieved.The coating may be, for example, a Parylene coating formed using achemical vapor deposition (CVD) method. It may also be possible for theouter face to be coated in areas, for example by the CVD method, suchthat the outer face of the prosthesis liner may be provided with areashaving different properties. For example, the area located proximallywith respect to the sealing lip may be provided with a smooth coating,such that a movement of the prosthesis liner relative to the prosthesissocket may easily take place proximally with respect to the sealing lip,whereas the area of the outer face of the prosthesis liner locateddistally with respect to the sealing lip has particularly good adherenceto the inner face of the prosthesis socket. In an alternativeembodiment, it is possible that the outer face of the prosthesis liner,distally with respect to the sealing lip, has a particularly smooth wallin order to permit relative movement. The relative movement may providea pump effect between the inner face of the prosthesis socket and theouter face of the prosthesis liner.

Providing an adhesive on the surface of the liner located proximallywith respect to the sealing lip may provide increased adherence of theprosthesis liner to the prosthesis socket, which may provide the user ofthe prosthesis liner with an enhanced feeling of stability. The outerface of the prosthesis liner may likewise be provided with a matrix, forexample a lattice, which serves to strengthen the main body and toprovide increased resistance to incipient tearing or to continuedtearing of the main body in the event of damage.

The outer face of the prosthesis liner may include an at least partiallyroughened surface structure, in particular distally with respect to thesealing lip, in order to avoid a situation where the liner portionlocated distally with respect to the sealing lip adheres to the surfaceof the prosthesis socket. The surface structure may facilitate thevacuum distribution. The surface structure may include microstructuresformed on the surface. The microstructures may facilitate the vacuumdistribution and may be interconnected with each other.

The surface structure may ensure the distribution of the vacuum as faras the sealing lip. If a socket valve is present, sealing in immediateproximity to the socket valve may be problematic in the case of a verysmooth design of the outer face of the liner, since a vacuum would thenbe applied to only a very small area. When the outer face of theprosthesis liner is not adhering in the distal area of the sealing lipor flow channels for provided on the outer face, it may be easier todetach the outer face of the prosthesis liner from the inner face of theprosthesis socket and to achieve pressure distribution, as a result ofwhich a renewed reduced pressure or a uniform vacuum is made availableas far as the sealing lip, thereby permitting a more secure holding ofthe prosthesis socket on the prosthesis liner.

In one embodiment, strips of a material different from the material ofthe main body are arranged on the inner face and/or the outer face ofthe prosthesis liner. The different materials are distinguished bydifferent chemical and/or physical properties. In particular, areas ofincreased or reduced adherence, elasticity and/or color may be achievedin this way. The different materials may be generated by additives in abase material from which the main body is likewise made. Instead ofproducing the strips using a base material the same as the material ofthe main body, different materials or other elastomer types may also beembedded or cast in the outer face and/or inner face of the prosthesisliner. The strips may also be knife-coated. The strips may haverectilinear or curved contours and may be arranged spaced apart from oneanother on the outer face and/or inner face of the main body.

In another embodiment, at least one matrix with isotropic properties, inparticular with isotropic elasticities, is embedded in the main body.The matrix serves as a reinforcing matrix and, for example, preventsincipient tearing or continued tearing in the case of a partiallydamaged prosthesis liner. The matrix may be designed corresponding tothe prosthesis liner and may be arranged both in the distal end area andalso in the side wall and be surrounded by the material of the mainbody. It is likewise possible that the distal end area of the prosthesisliner is free of a matrix, but the side wall includes the matrix. Thematrix may be designed as a circumferentially closed sleeve. The matrixmay extend as far as the proximal edge of the prosthesis liner extendingabout the proximal access opening. The matrix does not have to besurrounded by the material of the main body at the proximal edge.

In one embodiment, several matrices are embedded in the main bodyseparately from one another. For example, the matrices may be worked ina strip shape into the side wall in the longitudinal extent of theprosthesis liner, the matrices having isotropic elasticities, whereinthe material of the respective matrix has a lower elasticity than thematerial of the main body. It is thereby possible to limit an elongationof the prosthesis liner in the longitudinal extent, and yet to permit avolume compensation through the interspaces between the matrices or tocompensate a change of volume. In this way, a sufficient longitudinalstability against the so-called milking effect is achieved via thematrices without disproportionately limiting the elasticity in thecircumferential direction for compensation of volume fluctuations. Thestrips may have straight or curved contours and may be arranged spacedapart from one another on the outer face and/or the inner face of themain body. The undulating shape serves to ensure that any folds thatoccur are guided in defined paths, such that many minimal,non-disruptive folds are obtained.

In other embodiments, several matrices with different elasticities maybe embedded in the main body. One type of matrix in the form of severalstrips spaced apart from one another may be embedded in the main body,wherein the material of the respective matrix strip substantiallysuppresses an elongation. Matrices made of a material with acomparatively high elasticity, in particular an elasticity equal to orgreater than that of the base material of the main body, may be embeddedin the area of the interstices between the matrices of the first type ofmaterial. However, this material may have an increased tear resistanceor cutting resistance compared to the material of the main body, suchthat an elongation along the longitudinal extent of the prosthesis lineris prevented via the matrices of the first type of material, whereas anelasticity in the circumferential direction is not limited by thematerial of the second matrices. In addition, increased tear resistancemay be afforded by the embedded materials of the two material types.

The first inelastic matrix may be embedded in the main body,circumferentially spaced apart from an elastic second matrix. It is alsopossible that the two matrices partially overlap in the circumferentialdirection. It is also possible that strips made of a flexible, inelasticmaterial as the first matrix are embedded in the main body spaced apartfrom one another in the circumferential direction, and the second matrixcomposed of a flexible and elastic material is sleeve-shaped with aclosed circumference and is embedded in the base material, radiallyspaced apart from the first matrix or the strips. The matrices may beseparated from one another by the base material or may also bearpartially or completely on one another.

The matrices may be arranged exclusively medially and laterally withrespect to a natural joint in a fitted state, as a result of which thebending of the joint, in particular bending of the knee joint, is notinfluenced or is influenced to a minimal extent. The strips may extendin the area of the compromise pivot point of the joint.

A receiving seat for a pump arrangement may be arranged in the mainbody, which pump arrangement conveys air out of the cavity delimited bythe sealing lip, by the inner face of the prosthesis socket and by theouter face of the prosthesis liner, or out of the interior of theprosthesis liner in which the stump is located. In addition to the pumpeffect, the pump arrangement may be used in the loading and unloading ofthe prosthesis liner in the use of the prosthesis. The receiving seatfor the pump arrangement may be arranged at the distal end of the mainbody.

The main body of the prosthesis liner may be made of an elastomermaterial, in particular a silicone or a polymer such as thermoplasticcopolymer or polyurethane.

The main body may be made at least partially of an air-permeablematerial and is sealed off distally. A sealing cap made of anair-impermeable material may be arranged on the outer face of the mainbody in order to provide a distal seal.

BRIEF DESCRIPTION OF DRAWINGS

Illustrative embodiments of the invention are explained in more detailbelow with reference to the attached figures, in which:

FIG. 1 shows a side view of a prosthesis liner;

FIG. 2 shows a sectional view of the prosthesis liner according to FIG.1;

FIG. 3 shows a sectional view of a variant of a prosthesis liner;

FIG. 4 shows a further variant of the prosthesis liner with a proximallydisplaced sealing lip;

FIG. 5 shows a variant of FIG. 4 with an embedded matrix;

FIG. 6 shows a sectional view of the prosthesis liner with apump-receiving seat;

FIG. 7 shows a variant of FIG. 6;

FIG. 8 shows a variant of FIG. 5 with a distal sealing lip and asleeve-shaped matrix;

FIG. 9 shows a sectional view through a prosthesis liner with a proximalsealing lip;

FIG. 10 shows a detailed sectional view of a prosthesis liner with acast-on sealing lip;

FIG. 11 shows a variant of FIG. 10 with a cast-in sealing lip;

FIG. 12 shows a sectional view of a prosthesis liner with embeddedstrips on the inner face;

FIG. 13 shows a side view of a prosthesis liner with strips on the outerface;

FIG. 14 shows a side view of a prosthesis liner with embedded strips ofa matrix;

FIG. 15 shows a side view of a prosthesis liner with roughened distalsurface;

FIGS. 16a to 16c show an enlarged detailed view of the outer face in thedistal end area;

FIG. 17 shows a perspective view of a prosthesis liner with a distalpump piston;

FIG. 18 shows a sectional view of FIG. 17;

FIG. 19 shows a variant of the present disclosure withmedially/laterally arranged matrices;

FIG. 20 shows a system composed of prosthesis liner and prosthesissocket in a sectional view;

FIG. 21 shows a variant with a distal sealing cap;

FIG. 22 shows a variant of FIG. 3 with a distal sealing lip and a curvedliner;

FIG. 23 shows a variant of FIG. 22;

FIG. 24 shows a variant of FIG. 21;

FIG. 25 shows a variant of FIG. 24 with a pin;

FIG. 26 shows a top view of a liner according FIG. 3;

FIG. 27 shows a variant of FIG. 26;

FIG. 28 shows a sectional view of a multi-layer prosthesis liner;

FIG. 29 shows a variant of FIG. 28;

FIG. 30 shows a variant of FIGS. 29; and

FIG. 31 shows a lower leg liner in a horizontal sectional view.

DETAILED DESCRIPTION

FIG. 1 shows a side view of a prosthesis liner 1, which is provided forfitting over a stump of a limb. The prosthesis liner 1 is typicallyprovided for fitting on, for example, an upper arm stump or a thighstump. The prosthesis liner 1 has a main body 10, which has an innerface directed towards the skin of the stump and an outer face 12directed away from the stump. An access opening 13 is present at itsproximal end, and a closed distal end area 15 is formed at its distalend, from which a side wall extends as far as the proximal accessopening 13. The prosthesis liner 1 in hollow on the inside and haseither an inner contour adapted to the shape of the stump or acylindrical or frustoconical inner contour, in each case with a closeddistal end portion. The prosthesis liner 1 is thus designed as a hollowbody open at one end. The main body 10 may be made of an elastomer, forexample polypropylene or polyethylene, or silicone.

A sealing lip 20 is arranged at the end of the distal end area 15 on theouter face 12 of the main body 10. The sealing lip 20 protrudes outwardsaway from the main body 10 such that a greatest circumference of thesealing lip 20 is greater than a circumference of the main body 10 inthe area of the sealing lip 20.

The sealing lip 20 has a portion 21, which is inclined or angled in thedirection of the access opening 13 and which extends outwards away fromthe main body 10. The portion 21 may be arranged at an angle relative tothe outer surface of the main body 10 in the range of about 5 degrees toabout 90 degrees, and more particularly in the range of about 30 degreesto about 60 degrees. The inclined portion 21 opens into an outer sealingedge 23, from which extends a proximal portion 22 of the sealing lip 20,which is oriented in the direction from the outer sealing edge 23 towardthe main body 10. In the illustrative embodiment according to FIG. 1,the outer contour of the sealing lip 20 is therefore roof-shaped orangular; both the inclined portion 21 and also the proximal portion 22are rectilinear in the state shown, e.g., in the state in which theprosthesis liner 1 is not inserted into a prosthesis socket (not shown).The inclined portion 21 and the proximal portion 22 may be arranged atan angle relative to each other. The angle may be in the range of about20 degrees to about 150 degrees, and more particularly in the range ofabout 60 degrees to about 120 degrees.

When the prosthesis liner 1 is inserted into a prosthesis socket, thesealing edge 23 first of all bears on the inner face of the prosthesissocket. When the prosthesis liner 1 is inserted further into theprosthesis socket, this generally has the effect that the sealing lip20, in particular the sealing edge 23, is pressed in the direction ofthe main body 10, as a result of which the proximal portion 22 is movedin its entirety proximally in the direction of the access opening 13.

FIG. 2 shows the prosthesis liner 1 according to FIG. 1 in a sectionalview. It will be seen from FIG. 2 that the distal end area 15 has agreater wall thickness than the side wall 14. The sealing lip 20 isformed integrally or cast onto the end of the distal end area 15. Thesealing lip 20 is thus either formed in one piece together with the mainbody of the prosthesis liner 1 or is configured as a separate componentand then secured on the main body 10 of the prosthesis liner 1, forexample by adhesive bonding or welding. Alternatively, the sealing lip20 may be cast onto the main body 10, or vice versa. Typically, thesealing lip 20 is fixed to and/or permanently connected to the main body10.

In the illustrative embodiment shown, the sealing lip 20 is made of thematerial of the main body 10, e.g., has a material composition identicalto that of the main body 10. It may also be possible to coat the sealinglip 20 on the outer face and/or inner face, for example, with a chemicalvapor deposition (CVD) coating, in order to modify the properties of thesealing lip 20, for example, in order to provide increased adherence orincreased friction resistance.

FIG. 3 shows an alternative embodiment in which a prosthesis liner 1 isshown in a sectional view. The distal end area 15 of the liner 1 has agreater material thickness compared to the rest of the side wall 14. Theincreased material thickness in the distal end area 15 may provideimproved cushioning and distribution of pressure forces, particularly inthe use as a prosthesis liner for a thigh socket or below-knee socket,since very high pressure forces develop in lower-limb prostheses whenthe user is standing or walking. The sealing lip 20 shown in FIG. 3, incontrast to the embodiment according to FIGS. 1 and 2, has a curvedcross section. The curvature of the sealing lip shown in FIG. 3 isconfigured such that the inclined portion 21 extends away from the mainbody 10. When viewed from the distal end, the inclined portion thus hasa concave curvature. The inclined portion 21 tapers towards the outside,such that a comparatively sharp sealing edge 23 is obtained at theradially outer end of the inclined portion 21 of the sealing lip 20.From the sealing edge 23, the proximal contour of the sealing lip 20runs distally again in the direction of the main body 10 and the sidewall 14, such that between the sealing edge 23 and the outer face 12 ofthe main body 10, a cross section of approximately triangular clearanceis formed which is completely or almost completely filled when theprosthesis liner 1 is inserted completely into a prosthesis socket.Provided that the sealing edge 23 is not compressed in the direction ofthe main body 10 so far that it bears on the outer face 12, a gap or awedge-shaped clearance is formed where the atmospheric pressure may act.In this way, when an reduced pressure arises in the cavity, whichpressure is formed between a prosthesis socket and the prosthesis liner1 and is separated by the sealing lip 20, the sealing lip 20 is pressedonto the prosthesis socket, as a result of which increased sealing isobtained when a reduced pressure arises in the distal area of thesealing lip 20. In the embodiment of FIG. 3, the sealing lip 20 isarranged approximately at the height of the middle of the prosthesisliner 1, e.g., much further in the proximal direction towards the accessopening 13 than in the embodiment according to FIGS. 1 and 2.

FIG. 4 shows a variant of FIG. 1 with a sealing lip 20, which isarranged further in the proximal direction as compared to theillustrative embodiment according to FIG. 1. In FIG. 4, the sealing lip20 is arranged proximally with respect to a first third of the length ofthe prosthesis liner 1 as measured from the distal end. At the distalend of the prosthesis liner 1, a pump arrangement 55 is arranged viawhich air or moisture may be sucked out of the interior of theprosthesis liner 1 in order to achieve an improved adherence of theinner face 11 of the prosthesis liner 1 to the stump (not shown).

FIG. 5 shows a variant of the arrangement according to FIG. 4 andincludes a matrix 40 which is embedded in the main body 10. The matrix40 corresponds in shape to the shape of the main body 10 and has asleeve-like side wall and a closed distal end area. The main body 10completely surrounds the matrix 40. The matrix 40 may optionallyprotrude from the material of the main body in the area of the proximalaccess opening 13 or may end flush with said material. Alternatively,the matrix 40 is applied on the outer face 12 or inner face of the mainbody 10 and may provide reinforcing material independently of thelocation of the securing in or on the main body 10.

FIG. 6 shows a sectional view according to FIG. 4, but without a pumparrangement. The sectional view of FIG. 6 shows a receiving seat 50 forthe pump arrangement 55. From the receiving seat 50, channels areindicated extending in the direction of the interior of the prosthesisliner 1, from which air and/or moisture may be sucked and transportedout of the prosthesis liner 1. Moreover, reinforcement elements, or aconnection plate in front of the pump elements, or a locking mechanismare arranged in the distal end.

FIG. 7 is a sectional view showing a part of a pump arrangement 55 inthe receiving seat 50. A pin 54 of the pump arrangement 55 is connectedto (e.g., screwed into) the receiving seat and produces a connection tothe actual pump, which is not shown. The pump mechanism is actuated byaxial loading in the direction of the longitudinal extent of theprosthesis liner, such that air may be sucked out of the interior of aprosthesis socket (not shown) and transported away.

Analogous to the embodiment according to FIGS. 1, 2 and 4 to 6, thesealing lip 20 shown in FIG. 7 has a proximal portion 22, which endsbefore the outer face 12 of the side wall 14, such that an annular gapis formed around the main body 10 from the side wall 14 as far as theproximal edge of the sealing lip 20. In one embodiment, the proximalportion 22 may extend all the way to the surface of the outer face 12 ofthe side wall 14 without being connected to the main body. The sealinglip 20 is only secured distally on the main body 10 or cast onto or intothe main body 10. In the event of a radially inwardly acting pressure,the sealing edge 23 is shifted inwards in the direction toward the mainbody 10, as a result of which the proximal edge of the sealing lip 20 ismoved upwards (proximally) on the outer face 12 of the main body 10. Therestoring force of the elastic sealing lip 20 thus exerts an increasedpressing force on the prosthesis socket (not shown) due to deformationof the sealing lip 20 as it is pressed toward the main body 10.

FIG. 8 shows a variant of FIG. 5 in which the sealing lip 20 is arrangedfurther distally. In addition, the distal end area 15 does not includethe matrix 40. The matrix 40 is configured elastically in acircumferential arrangement such that a radial widening of the side wall14 may take place. The material of the matrix 40 is flexible and may beresistant to tearing. If the main body 10 is made of an elastomermaterial or silicone and is damaged, a tendency to further tearing islessened because of the material of the matrix 40. The matrix 40 isdesigned like a mesh, a lattice or a textile and has free spaces throughwhich the material of the main body 10 passes. The matrix 40 may becompletely embedded in the main body 10, such there is no contact to theouter face 12 or to the inner face 11. Alternatively, the matrix 40,particularly if it is not a textile, may also be arranged at least insome areas on the outer face 12 of the main body 10, such that it bearson the main body 10 and sinks only partially into the latter in order tobe secured there (e.g., is partially embedded in the main body 10). Thematrix 40 may be embedded completely or partially in the main body 10.Alternatively, the matrix 40 is adhesively affixed to the main body 10,knife-coated or welded thereto.

FIG. 9 shows a variant of the present disclosure according to FIG. 7 inwhich the sealing lip 20 is arranged further proximally, approximatelyat the midpoint of the length of the prosthesis liner 1. There is no pinor reinforcing plate or the like arranged in the distal end area 15,e.g., for a pump arrangement. Typically, the farther the sealing lip 20is positioned away from the distal end area 15, the greater the size ofthe cavity within which the suction condition is provided, thuspermitting formation of a greater suction force.

FIG. 10 shows the sealing lip 20 on the main body 10. The sealing lip 20has a portion 21 inclined obliquely in the direction of the accessopening 13 at an angle θ, a sealing edge 23 protruding radially outwardin the proximal direction, and a proximal portion 22 extendingproximally from the sealing edge 23 in the direction of the main body.The proximal portion 22 is arranged at an angle α relative to theportion 21. Typically, the angles θ and α are each in the range of about30 degrees to about 60 degrees, although angles in the range of about 10degrees to about 150 degrees for one or both of θ and α are possible insome embodiments. The proximal portion 22 ends before contact with themain body 10, such that an annular gap and free space is formed betweenthe proximal end of the sealing lip 20 and the main body 10 when theliner is removed from a socket (e.g., in a rest or undeformed state).The sealing lip 20 encloses a cavity and may be cast onto the main body10. The main body 10 may first of all be partially cross-linked, then acasting mould is placed around the main body 10 and the sealing lip 20cast onto the main body 10, such that in the contact area at the foot 24of the sealing lip 20, a crosslinking takes place between the materialof the sealing lip 20 and the material of the main body 10. The twomaterials may be identical, but there is also the possibility of usingdifferent materials or material variants by addition of additives inorder to meet the different requirements of the main body 10 and thesealing lip 20. For example, the main body 10 may have less elasticitythan the sealing lip 20, or vice versa.

FIG. 11 shows a variant of the present disclosure in which the sealinglip 20, which is designed analogously to the sealing lip 20 of FIG. 10,is cast into the main body 10. The sealing lip 20 is first of allproduced separately and then cast in in the distal area of the inclinedportion 21. The cast-in area may have a thickening such that, inaddition to crosslinking, a secure form-fit engagement of the sealinglip 20 on and in the main body 10 takes place.

A common feature of all the sealing lips 20 in FIGS. 1 to 11 is thatthey have a radial circumferential configuration, e.g., extend about theentire circumference of the main body 10 of the prosthesis liner 1. Inaddition to the embodiments having only one sealing lip 20, it ispossible in other embodiments to provide several sealing lips spacedapparat along the longitudinal extent of the prosthesis liner 1.

FIG. 12 shows a further embodiment in a sectional view of the prosthesisliner 1 with a coating on the inner face 11 of the prosthesis liner. Thecoating 30 is applied in the form of strips 30 to the inner face 11, forexample, by a CVD method, so as to be able to produce different surfaceproperties in certain areas. In addition to coating by the CVD method,it is possible in the areas of the strips 30 for other materials to becast in or cast on or otherwise secured in order to be able to achievethe desired properties on the inner face 11 of the prosthesis liner 1.In addition to the coating, or instead of the coating, a matrix may becast on the main body 10 as a stabilizer or stiffener in strips formedin this way.

FIG. 13 shows a further variant of the present disclosure in whichstrips 30 are arranged or formed on the outer face 12 of the prosthesisliner. The strips may be rectilinear or, as shown, formed in undulatingshapes. The strips 30 may be spaced regularly apart from each other and,for example, may be made of an elastomer different than the material ofthe main body 10. The elastomer may be, for example, a silicone with ahigher degree of hardness than the silicone of the main body 10. Thesealing lip 20 may cover the strips 30.

FIG. 14 shows a further variant of the present disclosure in whichstrip-shaped matrices 40 are embedded in the main body 10. The matrices40 may have an isotropic elasticity and, for example, prevent stretchingin the longitudinal extent of the main body 10. The matrices 40 may bespaced apart from each other circumferentially such that no inelastic,flexible matrix is arranged between the matrices 40, thereby permittinga change of volume, in particular an increase of volume, of theprosthesis liner 1. A lengthwise elasticity in the side wall 14 is thuslimited by the matrices 40 in order to reduce the so-called milkingeffect, without excessively restricting the change of volume that occurswhen the prosthesis liner 1 is being worn. The matrices 40 may also bedesigned as in FIG. 12, supplemented by an additional elastic matrix inorder to increase the resistance to further tearing.

FIG. 15 shows a further variant in which the surface on the outer face12 of the main body 10 has a roughened surface structure 121, both inthe area of the distal end area 15 and also in the area of the side wall14 adjoining the latter in the proximal direction. The roughened surfacestructure 121 is provided distally with respect to the sealing lip 20.

The roughening may be better seen in FIG. 16a . The roughening preventsa situation where the area located distally with respect to the sealinglip 20 bears fully on the inner face of the prosthesis socket andadheres thereto so that there is no pump effect or only a reduced pumpeffect. The roughness or the surface structure on the outer face 12 inthe area distally of the sealing lip 20 facilitates the production,distribution and formation of a vacuum distally with respect to thesealing lip 20.

The sealing lips 20 disclosed herein may be arranged at differentheights (e.g., extending different distances from an outer surface ofthe main body 10 when the sealing lip 20 is in a rest state when theliner is removed from a socket). Several different sealing lipconfigurations may be combined with one another. For example, theembodiment according to FIG. 3 may be combined with one or more sealinglip configurations according to FIG. 2, 6 or 9. The sealing lipconfiguration according to FIG. 3 may be arranged or configured as aproximal, medial or distal sealing lip combination with one or moreother sealing lips 20 on the outer face 12 of the prosthesis liner 1.Moreover, several different ways may be provided for securing thesealing lips 20 on the prosthesis liner 1. For example, sealing lips 20may be cast on, cast in and/or otherwise secured or formed on the mainbody 10, for example by adhesive bonding or welding.

When several sealing lips are used, the sealing lips may be made ofdifferent materials with different degrees of hardness, differentelasticities or different surface coatings or may have differentcoatings.

The various possibilities of the combination of the sealing lips 20 withone another may be combined with an inner coating and/or outer coatingof the main body 10. The coating may be applied to the inner face 11and/or outer face 12 of the main body 10 either in some areas or acrossthe whole surface.

In addition to a coating, strip-shaped material inlays made of adifferent material may be placed in the main body 10 or applied on themain body 10. Moreover, strip-shaped or circumferentially closedmatrices 40 may be arranged on or in the main body 10, in particular byadhesive bonding, embedding or encapsulation. The matrices 40 may alsobe combined in combination with a coating on the outer face 12 and/orinner face 11, a complete or partial coating and/or an additionalincorporation or alternative incorporation of material strips on theinner face 11 and/or outer face 12 of the main body 10.

FIG. 16b shows a further variant of the present disclosure in whichregular depressions are arranged between elevations 122. In FIG. 16b ,the elevations 122 are designed as rectangles or blocks which are raisedin relation to the main face of the main body 10 in the distal area.Interconnected flow channels are formed between the elevations 122, suchthat a surface structure or a surface roughness with raised knobs isformed. A pressure compensation may then easily take place between theseknobs, such that, upon establishment of a reduced pressure or of avacuum, the latter distribute themselves uniformly in the distaldirection as seen from the sealing lip 20. This arrangement prevents asituation where a non-uniform reduced pressure develops or where anreduced pressure is present only in some areas distally from the sealinglip 20, which situation may lead to an unpleasant feel for the wearer.

FIG. 16c shows a variant of the present disclosure in which, instead ofpolygonal elevations 122 or polygonal blocks 122, the latter are oval.The surface of the elevations 122, irrespective of their shape, ispreferably a flat face, so as to be able to provide sufficiently stablemechanical bearing on the inner face of the prosthesis socket withoutcausing local pressure peaks. In addition to a rectangular or oval shapeof the elevations 122, these may also be round, polygonal, irregular orany other desired shape.

FIG. 17 shows a development of the present disclosure in which a pumppiston 56 is arranged on the distal end area 15 at the distal end of theprosthesis liner 1, which pump piston 56 interacts with a cylindricalreceiving seat (not shown). A non-return valve is arranged in the pumppiston 56 and is connected to a flow channel (not shown) in the pistonshaft. By way of this non-return valve, air is transported away from thespace (not shown) between the outer face 12 of the distal end area 15distally with respect to the sealing lip 20 and is transported away viaa pump arrangement in interaction with a cylinder in the shaft.

FIG. 18 shows the configuration according to FIG. 17 in a sectionalview. The pump piston 56 is secured in the receiving seat 50 in thedistal end area of the liner. In one example, the piston 56 is screwedin to the receiving seat 50. The air is transported away from theinterspace via the flow channel 57 and the non-return valve 58. Thenon-return valve 58 prevents a return flow of the air, such that duringa relative movement between the distal end portion or the pump piston 56and the prosthesis socket, an reduced pressure builds up on account ofthe pump action. The sealing edge 23 is pressed in the distal directionby the overpressure located proximally with respect to the sealing edge23, which leads to increased pressing against the inner wall of theprosthesis socket (not shown).

FIG. 19 shows a further variant of the present disclosure in which amatrix 40 in the form of a strip extending in the lengthwise extent ofthe prosthesis liner is arranged inside the main body 10 or on the outerface 12 or the inner face 11. The matrices 40 are located onsubstantially opposite sides of the prosthesis liner 1 and, when theliner 1 is fitted on a stump, extend through a compromise pivot point 80of a natural joint (not shown) over which the prosthesis liner isfitted. The matrices 40 extend exclusively laterally and medially withrespect to the stump and have the advantage that, on account of themedial/lateral arrangement, a flexion of a joint, for example a kneeflexion, is not affected or is only minimally affected. In particular inflexible inelastic matrices 40, a longitudinal stability of theprosthesis liner 1 is thereby achieved without impairing the mobility ofthe stump.

FIG. 20 shows a cross-sectional view through a system composed of aprosthesis socket 100 with a prosthesis liner 1, wherein the prosthesisliner 1 includes one or more features of the embodiment according toFIGS. 17 and 18. The radially outer sealing edge 23 bears on the innerface 111 of the prosthesis socket 100. The prosthesis socket 100 is madeof a dimensionally stable material and has a substantially closed crosssection. At least the cross section distally with respect to the bearingsurface of the radially outer sealing edge 23 is closed. A closed crosssection in this context includes a continuous structure along aperiphery and/or circumference of the structure, even if the structureincludes a hollow central portion.

Between the outer face 12 of the prosthesis liner 1 and the inner face111 of the prosthesis socket 100 shown in FIG. 20, a cavity 110 isformed, which is closed proximally by the sealing edge 23. The cavity110 is sealed off distally and radially by the prosthesis socket 100 andis sealed off on the inner face 111 by the prosthesis liner 1. Areceiving plate for the pump piston 56 is arranged at the distal end ofthe prosthesis liner 1. A carrier 150 with a cylinder 151 is formed inthe distal end area of the prosthesis socket 100.

The pump piston 56 shown in FIG. 20 is inserted in the correspondinglyshaped cylinder 151. A second non-return valve 158 is arranged in thecarrier 150, such that air from the volume between the piston 56 and thecylinder 151 may be forced out into the environment. A return flow ofair from the environment is blocked by the non-return valve 158. In aproximal movement of the piston 56, a relative reduced pressure isgenerated distally with respect to the piston 56 in the volume formed bythe piston 56 and the cylinder 151, such that air from the cavity 110may flow into the interspace through the non-return valve 58. In adistal movement of the piston 56, for example, on account of themovement and at set-down, this air is then forced back out again. Thisimproves the securing of the prosthesis liner 1 in the prosthesis socket100 on account of the increased vacuum.

A further variant of the present disclosure is shown in FIG. 21. Themain body 10 of the prosthesis liner 1, at least proximally with respectto the sealing lip 20, is made of a breathable material, for example atextile, in particular a 3D spacer knit, which is designed as a closedliner, open at one end, and completely encloses the stump. The liner andthe main body 10 have a closed distal end area 15 which surrounds thestump (not shown) distally and circumferentially. A sealing cap 200 isintegrally formed and cast on the outer face of the main body 10. Thecap 200 may be made of an elastomeric, air-impermeable or substantiallyair-impermeable material, for example, silicone or a polymer. Thesealing cap 200 forms the sealing lip 20 at its proximal end portion,and provides sealing distally with respect to the sealing lip 20.

As is shown in FIG. 21, the sealing cap 200 may finish relatively fartowards the distal end. Alternatively, the sealing cap 200 may extend asfar as the middle of the main body 10 or proximally beyond this. Anair-permeable, for example, textile, main body 10 is then located on theinner face of the sealing cap 200 and is sealed off by the sealing lip20 with respect to the prosthesis socket. The sealing cap 200 isconnected over a large surface area to the outer face 12 of the mainbody 10, for example, by casting the sealing cap 200 onto the main body10 or by adhesive bonding or other securing methods. The sealing cap 200may be pulled over the main body 10, thus eliminating the need for apermanent securing if the adherence to the outer face of the main body10 is great enough.

As an alternative to circumferentially securing the main body 10 to thesealing cap over a large surface area, it is possible to design the mainbody 10 as a hose made of an air-permeable (e.g., textile) material. Thesealing cap 200 with the sealing lip 20 may be cast onto the distal end.Both variants achieve the aim of making available a breathable linerwith which distal locking in a prosthesis socket may be achieved at thesame time with volume control. Removal of perspiration may also bepossible by making the main body 10 from a breathable, air-permeablematerial. In addition to the breathable, air-permeable material being inthe form of a 3D spacer knit, other textiles or open-pore materials mayalso be used, such as perforated elastomers, foams or the like.

Regardless of the material from which the main body 10 is made, theinner face 11 of the liner 1 may be provided with a coating which, inaddition to a sealing effect, permits and improves adherence to the skinof the user. Alternatively or in addition, the inner face of the liner 1may be provided with a surface structure or a coating which makesavailable a direction-dependent resistance. The resistance is increasedwith respect to a pulling-off movement or a rotation movement about thelongitudinal axis of the stump, such that placing the stump in the lineris made easier and pulling the stump out is made more difficult. Inaddition, the position of the liner on the stump is secured. A so-calleddog skin effect is obtained, similar to a velour nap.

FIG. 22 shows a sectional view of a prosthesis liner 1, whichcorresponds in its structure and set-up basically to the liner as shownin FIG. 3. In the embodiment of FIG. 22, the distal end area 15 isprovided with a greater material thickness compared with the materialthickness in the side wall 14. The sealing lip 20 has a curved sectionand is integrally formed together with the main body 10. The inclinedportion 21 bulges (e.g., in a bent or curved shape) in an outwarddirection to create a concave curvature on the distal side of thesealing edge 23 when viewed angularly from below onto the sealing lip.On the back side, i.e. on the proximal side of the sealing lip 20, acorresponding convex curvature is provided so that there is anintermediate space in form of a “V” between the proximal side of thesealing lip 20 and the outer face 12 of the side wall 14 of theprosthesis liner 1.

In a proximal direction as viewed from the sealing lip 20, the side wall14 is precurved or preformed in a curved manner so that the prosthesisliner is provided with a buckling or a kink when the liner is not donned(e.g., when the liner is in an unstressed or unloaded situation and hasa given form stability without forces acting from the outside onto theliner). The kink or the buckling in the prosthesis liner may be providedin a way that is receptive of a natural joint of the wearer. If theprosthesis liner 1 is designed as a liner for a lower extremity, a shankof the lower extremity may be inserted into the liner up to the distalend area 15. The prosthesis liner 1 is dimensioned so that the curvatureor bend is positioned in the area of a natural knee joint. The frontalarea is provided with a buckle, bulge or vault 16 for a patella, toprovide an improved contact of the liner with the lower extremity. Ifthe liner is designed for an upper extremity, the buckle, bulge or vault16 is positioned on the rear side in the area of, for example, theelbow, whereas the flexed part or dent is positioned in the area of, forexample, the crook of the arm.

The main body 10 is tapered in the area proximal to the vault 16, sothat there are three material thicknesses with smooth transitionsbetween them. The different material thicknesses are arranged in a waythat an increased material thickness is provided in the distal end area15 in order to receive pressure forces and to distribute the receivedpressure forces more evenly. A medium sized material thickness isprovided proximal to the distal end area 15 to provide a sufficientstability and sufficient material for forming the sealing lip 20integrally with the liner. A thin material thickness is provided in aproximal direction after the vault 16 for improved sensation in the areaof a thigh or upper arm when the prosthesis liner is donned.

FIG. 23 shows an alternative embodiment of the liner shown in FIG. 3.The liner according FIG. 23 has a longer insertion area after the vault16 compared to the embodiment of FIG. 3. Furthermore, the sealing lip 20is arranged further proximal to the distal end area 15 so that the lineraccording FIG. 23 is suited especially for patients with a long stumpdistal to a natural joint. Other features and functionality of the linershown in FIG. 23 are the same or similar to those features describedwith reference to the embodiment of FIG. 3.

FIG. 24 shows a further variant of the prosthesis liners shown in FIGS.22 and 23 in a sectional view. The sealing lip 20 has the form of thesealing lip 20 according to FIGS. 22 and 23 and therefore is formedcorresponding to the sealing lip 20 of FIG. 3. The sealing lip 20 shownin FIG. 24 is positioned considerably closer to the distal end area 15of the prosthesis liner 1 as compared to the embodiment of FIG. 3. Hereagain a slightly thicker wall is provided in the distal end area 15. Thesealing lip 20 is an integral part of the outer material so that theouter material and the sealing lip are formed as a single piece. Thesealing lip 20 is part of the sealing cap 200, which may extend in theembodiment of FIG. 24 over the entire length of the side wall 14 of theprosthesis liner 1.

The sealing cap 200 shown in FIG. 24 has an inner face 201 and an outerface 202, the outer face 202 is directed in an outward direction awayfrom the stump, whereas the sealing lip 20 extends from the outer face202 further radially away in an outwardly direction. The main body 10 isarranged on the inner face 201 of the sealing cap 200. The outer face 12of the main body 10 lies on the inner face 201 of the sealing cap 200and is coupled with the sealing cap 200, for example, by adhesivecoatings on the outer face 12 and/or the inner face 201, by bonding,welding or by form fitting elements which are established or arrangedcorrespondingly on the outer face 12 and/or the inner face 201.

A form fitting connection between the main body 10 and the sealing cap200 shown in FIG. 24 may be formed by matching protrusions and recessesor hook and loop areas additionally, or as an alternative, to a fixedbonding formed by, for example, welding or adherence. An advantage of aform fitting connection is that the main body 10 may more easily beremoved from the sealing cap 200.

The main body 10 includes an increased material thickness in its distalend area 15 as compared to the proximal end area. The material thicknessmay be decreased continuously from the distal end area 15 to theproximal access opening 13. It may be possible to establish steps in thethickness of the material, whereas the inner face 11 of the main body 10is preferably smooth and even without steps or recesses. The steps orrecesses are preferably positioned on the outer face 12 of the main body10 and may correspond to steps or recesses in the material of thesealing cap 200, so that a form fitting coupling of the main body 10 andthe sealing cap 200 against a pull-out direction from the distal endarea 15 in direction to the proximal access opening 13 is provided.

The form of the prosthesis liner 1 according FIG. 24 is straight andsleeve-like with a closed cross section. The shape of the liner 1permits the prosthesis liner to completely surround the stump. The shapeof the liner 1 also provides a preformed flection or bending, as shownin FIGS. 22 and 23, with a multi-part liner made from two or moredifferent materials as shown in FIG. 24. The main body 10 may be madefrom a breathable material or from a 3D spacer knitting. The inner face11 may be provided completely or partially with an adhesive coating toenable or promote adherence of the prosthesis liner 1 to a stump. Themain body 10 may comprise an elastomeric material. The sealing cap 200may comprise a material different to the material of the main body, asdescribed in connection with FIG. 21.

FIG. 25 shows a variant of FIG. 24 having, in addition to the specificstructure of the prosthesis liner in the distal end area 15, part of apump arrangement or of an attachment element, similar to the embodimentshown in FIG. 7. A pin 55 is inserted in a receiving seat 50, which isembedded in the main body 10. The pin 55 is preferably screwed into thereceiving seat 50. The pin 55 provides a connection to a shuttle lock orto a pump arrangement, as disclosed and discussed in connection withFIG. 20. A pneumatic piston may be attached to the pin 55, the pneumaticpiston is guided in a cylinder and performs a pumping movement withinthe cylinder during the use of the prosthesis liner and during loadingand unloading of the prosthesis liner.

FIG. 26 shows a top view onto a prosthesis liner 1 in an unloaded state.The main body 10 of the prosthesis liner 1 has a basically circular orround cross sectional shape. The sealing lip 20 extends in a radiallyoutward direction from the main body 10 around a circumference of themain body 10. The sealing lip 20 has a circular cross section, whereasthe sealing lip 20 and the main body 10 are arranged concentrically toeach other so that the sealing lip 20 has a substantially constantradial extension or width. The outer circumference of the sealing edge23 is generally circular as well as the outer face 12 and the inner face11 of the main body 10.

A variant of the shape or contour of the prosthesis liner 1 is shown inFIG. 27 as a top view of an unloaded prosthesis liner 1. The prosthesisliner 1 maintains the form shown in FIG. 27, which is obtains at the endof a forming process, without lateral forces or transvers forces actingon the side wall 14. The prosthesis liner of FIG. 27 has anapproximately triangular form with rounded edges instead of a circularcircumference of the sealing edge as well as the outer face 12 or innerface 11 of the main body 10, respectively. The sides of the triangle areslightly curved in an outward direction. All prosthesis liners accordingto the FIGS. 1 to 25 may be provided with a circular basic form, afundamental form as shown in FIG. 26, or a variant or deviating form,which may be polygonal or approximately polygonal or especiallytriangular, as shown in the embodiment according FIG. 27. Furthermore, apreform or pre-bending or protrusion according to FIGS. 22 and 23 may beprovided with a cross section deviating from a circular cross section,for example, with a polygonal or triangular cross section with a roundededges and curved sides.

FIG. 28 shows a further variant of a liner 1 according to the presentdisclosure in a cross sectional view. The prosthesis liner 1 has amulti-layered construction. The main body 10 is provided on its outerface 12 with a sealing cap 200, which extends over substantially theentire outer face 12 of the main body 10. The main body 10 is in thisembodiment made from thermoplastic polymer (TPE), preferably made from athermoplastic copolymer, since TPE has a skin caring effect due to thewhite oil as part of the TPE. The sealing cap 200 may be formed with asmooth and even wall and may be made from silicon. The sealing cap 200is attached to the main body 10. To improve the adhering of the siliconof the sealing cap 200 to the main body 10, an intermediate layer 102 inthe form of a textile interply or a CVD-coating, preferably of Parylen,is applied to the main body 10. The sealing lip 20 may be, for example,cast-on, adhered or incorporated in the sealing cap 200 as an inlay. Asan alternative, the sealing lip 20 may be an integral part of thesealing cap 200. In an alternative embodiment of FIG. 28, the main body10 may comprise polyurethane instead of TPE.

FIG. 29 shows a further variant of the present disclosure with aprosthesis liner 1 having a main body with an outer face 12, and asealing cap 200 arranged on the outer face 12. The sealing cap 200extends over substantially the entire length of the side wall 14 up tothe access opening 13 or almost up to the proximal rim of the accessopening 13. The main body 10 may comprise silicon or other flexiblematerials. Silicon has the advantage that it is easy to clean so thatdeposits or soiling on the inner face 11 of the main body 10 may moreeasily be removed. The sealing cap 200 may comprise a material differentfrom silicon, for example, a polyurethane or copolymer material such asa TPE.

The sealing lip 20 may be, for example, casted-on or established on theouter face of the sealing cap 200. The sealing lip 20 may be made fromthe same material as the sealing cap 200. In an alternative to theembodiment of the sealing lip made from a material identical or similarto the material of the sealing cap, the sealing lip 20 may be made fromsilicon, so that there is a structure of the prosthesis liner with amain body 10 made from silicon, a sealing cap 200 made from polyurethaneor a copolymer, preferably a TPE, and a sealing lip 20 formed to thesealing cap 200. An intermediate layer 102 may be applied between thesilicon of the main body 10 and the sealing cap 200 to attach thesealing cap 200 or the intermediate layer securely and easily to themain body. The intermediate layer 102 may comprise silicone and bepositioned at least in part between the main body and a prosthesissocket.

The sealing cap 200 may be also described or function as an outer liner,and may comprise a polyurethane or a TPE. The intermediate layer 102 maybe applied by a CVD-method as an adhesion agent, for example, a layermade of Parylen. In an alternative to a Parylen layer, the intermediatelayer 102 may be provided as a textile interply to improve the adhesionof the polyurethane or of the TPE. An adhesion promoting layer may beapplied on the outer face of the sealing cap in an area in which theseparately manufactured sealing lip 20 has to be attached. The adhesionpromoting layer may be applied in a CVD-method and may be a Parylenlayer. In an alternative, a textile outer layer may at least partiallybe attached to the outer face of the sealing cap. The textile outerlayer is covered at least partially by the subsequently casted-on,bonded or otherwise attached sealing lip 20.

A further variant of the present disclosure is shown in FIG. 30 with amain body 10 comprising, for example, silicon. The sealing lip 20 may bean integral part of the base body 10. In an alternative, the sealing lip20 is manufactured as a separate part and attached to the main body 10in a separate assembly step. The intermediate layer 102 may be made fromParylen or a different material for an improved adhesion of the sealingcap 200 to the outer face 12 of the main body 10, thereby improving theadhesion of the sealing cap onto the silicon of the main body 10. Theintermediate layer 102 may be applied by a CVD-method. A textileinterply as an intermediate layer 102 may be casted-in. The sealing cap200 or the outer liner may comprise polyurethane. The sealing cap may beprovided on its outer face with a coating, which may be applied with,for example, a CVD-method.

A so-called hybrid liner, which comprises more than one material, mayhave an advantage that different properties or different materials atthe respective position may create different properties andcharacteristics for the liner. Silicon is typically relatively easy toclean and is durable so that silicon layer may establish a durablelayer. Polyurethane or thermoplastic elastomers, especially copolymers,may provide an adjustable function layer so that combined prosthesisliner 1 may be created that fulfils the requirements and the needs ofthe prosthesis user better than a prosthesis liner made of only a singlematerial. Improved characteristics and qualities may be achieved withidentical material thicknesses. On the other hand, similarcharacteristics, qualities and features of a single material liner maybe achieved with a reduced material thickness when using a hybrid liner.In particular, a hybrid liner having a silicon layer may be made thinnercompared to a prosthesis liner 1 made of silicon only.

Instead of coating an outer face 202 of sealing cap 200 via CVD, atextile or a textile outer layer may be attached on the outer face 202.The sealing lip 20 may protrude trough the textile layer or may beattached onto the textile layer.

The surface of the inner face 11 of the prosthesis liner may beroughened in all embodiments. The roughened structure or texture has theeffect of an enlargement of the surface so that an improved connectionof the inner face 11 of the prosthesis liner 1 with the skin of thestump may be achieved. Due to the improved adherence of the prosthesisliner 1 onto the stump, the other parts of a prosthesis, in particular aprosthesis socket, may be coupled more securely and more precisely tothe patient, so that the handling and the use of the entire prosthesismay be facilitated and improved. Furthermore, a roughened surface mayimprove the haptic and surface feel for the user and may provide a morepleasant sensation for the user. The roughened surface structure may beachieved by roughening the core of the moulding on which the main body10 of the prosthesis liner is manufactured. A roughened surface may beachieved, for example, by attaching, embossing, etching or grinding aregular pattern of protrusions and/or recesses. Furthermore, irregularor erratic protrusions and recesses may be attached to or implemented inthe surface of the core for moulding the liner to achieve acorresponding surface structure on the inner face 11 of the main body10.

To obtain a prosthesis liner in a pre-bent or pre-flexed form, such asshown in FIGS. 22 and 23, the main body 10, which may comprise TPE or alayer of TPE, may be drawn onto a template or cast of a stump which isalready flexed or bent. After attaching the originally straight lineronto the template, the liner is tempered so that the liner may take onthe form of the template. The temperatures for tempering depend on thechemical composition of the TPE and are usually between about 60° C. andabout 70° C.

A prosthesis liner with a pre-bent or pre-flexed form in accordance withthe present disclosure may be provided with a thinner material in thearea of the bending, for example, the knee pit or the crook of the armcompared to the opposite side, which means the side of the patella or ofthe elbow, respectively. By providing a thinner material in someportions of the liner, the bending of the prosthesis liner isfacilitated since the thinner material provides a reduced resistance anddoes not tend to crease or wrinkle so that a creasing or a wrinkling maybe reduced.

FIG. 31 shows a horizontal section of a prosthesis liner 1 with anapproximately triangular original form or basic form. Such a form issimilar to the form shown in FIG. 27 and may be advantageous for a linerof a lower leg or a liner for a shank, because the shin with the calfmuscles have an approximately triangular cross section. The main body 10may be inflated or drawn onto a template with a circular cross sectionto facilitate the attachment of a separate sealing lip 20 onto the outerface of the main body 10 if the main body 10 has a substantiallytriangular basis form. The sealing lip may be, for example, casted-in orbonded by adhesives to the main body. After attaching the main body 10onto the template, the sealing lip 20 may be casted-in or bonded ontothe main body 10. The liner may be removed from the template after thesealing lip 20 is adhered or cured with the main body 10. By thisprocess, the main body 10 may have an approximately triangular crosssection whereas the sealing lip 20 may have an approximately circularcontour when viewed from above (e.g., from a proximal end toward adistal end).

The foregoing description, for purpose of explanation, has beendescribed with reference to specific embodiments. However, theillustrative discussions above are not intended to be exhaustive or tolimit the invention to the precise forms disclosed. Many modificationsand variations are possible in view of the above teachings. For example,any of the features of any given embodiment disclosed herein may be usedwith any other embodiment. The embodiments were chosen and described inorder to best explain the principles of the present systems and methodsand their practical applications, to thereby enable others skilled inthe art to best utilize the present systems and methods and variousembodiments with various modifications as may be suited to theparticular use contemplated.

Unless otherwise noted, the terms “a” or “an,” as used in thespecification and claims, are to be construed as meaning “at least oneof.” In addition, for ease of use, the words “including” and “having,”as used in the specification and claims, are interchangeable with andhave the same meaning as the word “comprising.” In addition, the term“based on” as used in the specification and the claims is to beconstrued as meaning “based at least upon.” Throughout this disclosurethe term “example” or “exemplary” indicates an example or instance anddoes not imply or require any preference for the noted example. Thus,the disclosure is not to be limited to the examples and designsdescribed herein but is to be accorded the widest scope consistent withthe principles and novel features disclosed herein.

1. A prosthesis liner configured to fit over a stump of a limb, theliner comprising: a main body comprising: an inner face directed towardsa skin surface of the stump; an outer face directed away from the stump;a proximal access opening; a closed distal end portion; a side wallextending from the access opening to the closed distal end portion; anair-permeable material; at least one sealing lip arranged on an outerface of the main body and protruding radially outwards from the mainbody, the main body being sealed off distally with respect to the atleast one sealing lip.
 2. The prosthesis liner according to claim 1,wherein the side wall has a closed cross section.
 3. The prosthesisliner according to claim 1, wherein the at least one sealing lipcomprising a first portion connected to the main body and extending in adirection away from the main body, and the first portion of the at leastone sealing lip is straight or curved.
 4. The prosthesis liner accordingto claim 3, wherein the at least one sealing lip comprises a proximalportion extending proximally from the first portion in a directiontoward the main body, and the first portion and the proximal portion areintegrally formed as a single piece.
 5. The prosthesis liner accordingto claim 4, wherein the proximal portion bears on the outer face of themain body and is disconnected from the outer face.
 6. The prosthesisliner according to claim 1, wherein the at least one sealing lip is castonto the main body as a single-piece structure.
 7. The prosthesis lineraccording to claim 1, wherein the air-permeable material of the mainbody is at least one of textiles, open-pore materials, perforatedelastomers or foams.
 8. The prosthesis liner according to claim 1,wherein the at least one sealing lip comprises a material different thanthat of the main body.
 9. The prosthesis liner according to claim 3,wherein the first portion is partially embedded in the main body. 10.The prosthesis liner according to claim 1, wherein the at least onesealing lip extends around an entire circumference of the main body. 11.The prosthesis liner according to claim 1, wherein the at least onesealing lip is designed as a separate component and is secured or castonto the main body.
 12. The prosthesis liner according to claim 1,wherein the at least one sealing lip is arranged proximally with respectto a distal third of the main body.
 13. The prosthesis liner accordingto claim 1, wherein the outer face is free of textile or is providedwith a friction-reducing coating.
 14. The prosthesis liner according toclaim 1, further comprising a roughened surface structure positioned onthe outer face at a location distal of the at least one sealing lip, theroughened surface structure promoting vacuum distribution.
 15. Theprosthesis liner according to claim 1, further comprising strips of amaterial different than the material of the main body arranged on atleast one of the inner face and the outer face.
 16. The prosthesis lineraccording to claim 1, further comprising at least one matrix embedded inthe main body, the at least one matrix having isotropic elasticities.17. The prosthesis liner according to claim 16, further comprising aplurality of matrices with different elasticities embedded in the mainbody.
 18. The prosthesis liner according to claim 16, wherein the atleast one matrix includes at least a first inelastic matrix embedded inthe main body and circumferentially spaced apart from an elastic secondmatrix.
 19. The prosthesis liner according to claim 16, wherein the atleast one matrix is arranged medially and laterally in an area of acompromise pivot point of a joint.
 20. The prosthesis liner according toclaim 1, further comprising a piston pump or a pump piston arranged onthe main body, or a receiving seat for a pump arrangement arranged inthe main body.
 21. The prosthesis liner according to claim 20, whereinthe receiving seat is arranged at the distal end portion of the mainbody.
 22. The prosthesis liner according to claim 1, wherein at leastone of the main body and the at least one sealing lip comprises siliconeor a polymer.
 23. The prosthesis liner according to claim 1, furthercomprising a sealing cap made of an air-impermeable material, thesealing cap being arranged on the outer face of the main body distallyto the at least one sealing lip.
 24. (canceled)
 25. The prosthesis lineraccording to claim 23, wherein the sealing cap comprises a proximal endportion, and the at least one sealing lip is formed at the proximal endportion of the sealing cap.
 26. The prosthesis liner according to claim23, wherein the sealing cap is integrally formed and cast on the outerface of the main body.
 27. The prosthesis liner according to claim 23,wherein the sealing cap is connected to the main body by adhesivecoatings, bonding, welding, or form-fitting elements.
 28. The prosthesisliner according to claim 23, wherein the at least one sealing lip iscast-on, adhered or incorporated in the sealing cap as an inlay, or isan integral part of the sealing cap.